CHIG 4 LIBRARY Chigwell Urban District Council ANNUAL REPORT of the Medical Officer of Health Including the Report of the Senior Sanitary Inspector, For the Year ending December 31st, 1940. BUCKHURST HILL: Printed by John W. Phelp & Co., Queen's Road. 1 CHIGWELL URBAN DISTRICT COUNCIL. To the Chairman and Members of the Chigwell Urban District Council. Mr. Chairman, Ladies and Gentlemen, I beg to present the Annual Report for the year 1940 upon the health and sanitary circumstances of the district. Ministry of Health Circular No. 2814 of 26th March, 1941, directs that the report shall be an interim one, but that all records and statistics, including those to be supplied by the Registrar General, be carefully preserved, with a view to a more detailed report after the war. It is with pleasure that I take this opportunity of acknowledging the frequent and valuable help I have received from Professor M. Greenwood during the year and of expressing also my sincere thanks to the Staff of the Public Health Department, for their invariably cheerful and loyal co-operation, often under trying circumstances. I am, Your obedient Servant, L. S. FRY, M.D., D.P.H. 2 CHIGWELL URBAN DISTRICT COUNCIL. PUBLIC HEALTH COMMITTEE Owing to the National emergency, the Public Health Committee has been incorporated with the General Purposes, Finance, Housing and Town Planning and Valuation Committees and constituted as No. 2 Committee. (As at 31st December, 1940). Chairman: Councillor F. S. Foster, J. P., C.C. Vice-Chairman: „ E. Sutton-Pryce, B.D. Members : Councillor A. E. Gould. „ A. W. Golightly. ,, N. H. Hedges. ,, E. G. Perry. „ B. G. Platten. ,, J. Seabrook. ,, H. Spurr. „ T. E. Moore. „ S. G. Weaver, F.C.A. Meetings. These were held on the following dates:— 2nd January, 5th March, 30th April, 5th June, 2nd July, 3rd September and 2nd November, 1940. PUBLIC HEALTH STAFF. Medical Officer of Health: L. S. Fry, M.D.(Camb.), D.P.H. Hon. Assistant Medical Officer of Health: M. Greenwood, F.R.S., F.R.C.P. Senior Sanitary and Petroleum Inspector: J. T. Heath, M.R.San.I., M.S.I.A. Royal Sanitary Institutes Certificates for (i) Sanitary Inspector. (ii) Inspector of Meat and Other Foods. Sanitary Inspector : W. H. Digweed, A.R.San.I., M.S.I.A. (Seconded to Air Raid Precautions Dept.) Royal Sanitary Institute and Sanitary Inspectors Joint Board Certificate. Royal Sanitary Institute Certificate for Inspector of Meat and Other Foods. 3 Temporary Assistant Sanitary Inspector (January ist, 1940—May, 1940):— E. A. Ellis, A.R.San.I. Royal Sanitary Institute and Sanitary Inspectors Joint Board Certificate. Royal Sanitary Institute Certificate for Inspector of Meat and Other Foods. Temporary Assistant Sanitary Inspector (May, 1940—December, 1940): P. T. Shelton, A.R.San.I., A.A.I. Royal Sanitary Institute and Sanitary Inspectors Joint Board Certificate. Clerk : Miss J. Warriner. Section A. STATISTICS AND SOCIAL CONDITIONS OF THE AREA. Area (in acres) 8,970 (14 sq. miles approx.). Population (30th June, 1940) Reg. Gen. Figures—24,850 (estimated). Number of inhabited houses 7,843 Rateable Value £243,934 Sum represented by a Penny Rate £918 The rateable value has increased by over £3,342, as against over £20,000 in 1939. The sum obtained from a penny rate decreased by £2. The rate in the pound for 1940/41 was 14/-. The following information regarding unemployment for 1940 has been supplied by the Ministry of Labour. The figures relate to the district for which the Exchange operates, of which the Chigwell Urban District is a part only. Men. Women. Boys. Girls. Total. Wholly Unemployed, 1940 157 228 4 6 395 Temporarily suspended from work 11 3 0 0 14 168 231 4 6 409 Total Unemployed, 1939 383 258 23 26 690 4 VITAL STATISTICS. Male. Female. Total Live Births. Legitimate. 184 188 372 Illegitimate. 2 6 8 Total 380 Birth rate per 1,000 of estimated resident population: 15.3. Male. Female Total. Still Births. Legitimate. 6 6 12 Illegitimate. 0 2 2 Total 14 Rate per 1,000 total (live and still) births: 35.61. Male. Female. Total. Deaths 149 147 296 Death rate per 1,000 estimated resident population (standardised) 12.7. Deaths from Puerperal Sepsis 0 ,, ,, other Puerperal Causes 1 1 Deaths of Infants Under 1 Year Male. Female. Total. Legitimate. 9 5 14 Illegitimate. 0 1 1 Death rate of Infants Under 1 Year of age: All Infants per 1,000 live births 39 Legitimate Infants, per 1,000 legitimate live births 37 Illegitimate „ ,, „ illegitimate ,, „ 125 Deaths from Cancer (all ages) 50 ,, ,, Measles (all ages) 0 ,, ,, Whooping Cough (all ages) 0 ,, „ Diarrhoea (under 2 years) 3 „ ,, Road Traffic 3 ,, ,, Suicide 2 ,, ,, Other Violent Causes 27 5 Analysis of Deaths according to Age Incidence. Age. No. of Deaths. 1940. 1939. 1938. 1937. 1936. Under 1 year 15 11 11 8 18 1 and under 2 1 - 3 1 1 2 „ „ 5 4 1 2 3 — 5 „ „ 15 2 9 3 2 5 15 „ „ 25 7 9 3 2 7 25 „ „ 35 12 5 10 10 7 35 „ „ 45 20 16 14 13 9 45 „ „ 55 28 12 28 24 16 55 „ „ 65 50 36 33 30 26 65 ,, ,, 75 57 48 58 58 36 75 and upwards 96 63 57 51 69 Total 292 210 222 202 194 COMPARATIVE TABLE OF BIRTH AND DEATH RATE. Year. Estimated Population. Number of Births. Birth Rate per 1.000 of Population. N umber of Deaths. Death Rate per 1,000 (Standardised). Infant Mortality. Number of Deaths. Rate per 1,000 (I.ive Births). 1936 20,780 295 14.19 194 8.95 18 61 1937 22,510 319 14.17 202 8.57 8 25 1938 23,750 406 17.09 222 8.97 11 27 1939 25,100 416 16.57 210 8.09 10 24 1940 24,850 380 15.3 296 12.7 15 39 6 Birth-rates, Civilian Death-rates, Analysis of Mortality, Vlaternal Mortality and Case-rates for certain Infectious Diseases in the year 1940. (Provisional Figures based on Weekly and Quarterly Returns). — England and Wales. 126 County Boroughs and Great Towns including London. 148 Smaller Towns (Resident Populations 25 000 to 50.000 at 1931 Census). London Administrative County. Chigwell U.D.C. Rates per 1,000 Population. Births:— Live 14.6 16.0 15.7 13.7 15.3 Still 0.55 0.64 0.55 0.44 0.56 Deaths:— All Causes 14.3 15.8 12. 8 17. 8 12.7 Typhoid & Paratyphoid Fevers 0.00 0.00 0.00 0.00 0.00 Scarlet Fever 0.00 0.00 0.00 0.00 0.00 Whooping Cough 0.02 0.02 0.02 0.00 0.00 Diphtheria 0.06 0.07 0.05 0.01 0.00 Influenza 0.32 0.29 0.30 0.18 0.24 Smallpox - — — — — Measles 0.02 0.02 0.02 0.01 0.00 Notifications:— Enteric Fever 0.07 0.06 0.10 0.06 0.00 Cerebro Spinal Fever 0.32 0.33 0.29 0.28 0.08 Scarlet Fever 1.63 1.53 1.57 0.82 0.84 Whooping Cough 1.34 1.29 1.35 0.22 0.16 Diphtheria 1.16 1.29 1.21 0.61 0.08 Erysipelas 0.33 0.36 0.30 0.35 0.20 Smallpox 0.00 0.00 0.00 0.00 0.00 Measles 10.24 9.23 9.99 1.78 0.80 Pneumonia 1.20 1.37 1.00 0.87 0.56 Rates per 1,000 Live Births. Deaths under 1 year of age 55 61 54 50 39 Deaths from Diarrhoea & Enteritis under 2 years of age 4.6 5.9 4.4 5.8 7.92 Rates per 1,000 total Births (i.e., Live and Still). Maternal Mortality:— Excluding (abortion) Puerperal Infection 0.52 Not Available. 0.25 Others 1.64 - TOTAL 2 .16 0.25 Notifications:— Puerperal Fever 11.96 13.90 9.73 3.34 12.6 Puerperal Pyrexia 13.30 It will be seen that the birth rate for the district shows a slight fall, whilst the death rate has risen. The infant mortality rate also increased slightly. 7 Section B. GENERAL PROVISIONS OF HEALTH SERVICES IN THE DISTRICT. (a) Laboratory facilities. No change. (b) Ambulance facilities—no change. A summary of the work done by the Civil Ambulance is given below. AMBULANCE CALLS. Month. Number of Calls. Accident or other reason. Urgent Medical. January 14 2 12 February 15 4 11 March 15 3 12 April 5 1 4 May 14 7 7 June 13 7 6 July 8 6 2 August 16 8 8 September 37 12 25 October 24 10 14 November 28 11 17 December 18 8 10 207 79 128 (c) Nursing in the home. No change. (d) and (e) Clinics, Treatment Centres and Hospitals. During September and October, many persons from the heavily bombed areas in London were billeted in schools and halls in the district, and during this period a sick bay or convalescent home for 30 patients was opened in Loughton to provide better conditions and simple nursing for those unfit to remain in the rest centres. At the same time improvised clinics were established and held daily at three of the rest centres, and communal feeding arrangements set up at the halls and schools. 8 Diphtheria Immunisation: Clinics are held once a month at the following Child Welfare Centres:— Buckhurst Hill.—County Council Clinic, Buckhurst Way— 2nd Thursday in month at 2.30 p.m. Chigweli-St. Winifred's Church Hall—3rd Wednesday in month by arrangement (if required). Loughton Union Church Hall, High Road—2nd Friday in month at 2.30 p.m. Goldings Hill Mission Hall—3rd Thursday in month at 2.30 p.m. Roding Road Church Hall— 2nd Tuesday in month at 2.30 p.m. Tuberculosis Dispensary—Essex County Council.-For patients in the district:— County Council Clinic, Buckhurst Way, Buckhurst Hill—2nd and 4th Wednesday in month. Combined Treatment Centre, Regent Road, Epping—every Tuesday from 11 a.m. to 1 p.m. ESSEX COUNTY COUNCIL ACT, 1933. List of Establishments for Massage or Special Treatment. These establishments are licensed to 31st March, 1941. Mrs. J. M. Burt, Tresco, Knighton Lane, Buckhurst Hill. Miss E. Mackern, 45, Church Hill, Loughton. Miss C. Dewar, 100, High Road, Loughton. These premises have been inspected and are being carried on in a satisfactory manner. Section C. SANITARY CIRCUMSTANCES OF THE AREA. 1. (i) Water— The water supply for almost the whole district is derived from the Metropolitan Water Board, and is very satisfactory both in quality and quantity. There are a few isolated houses where the supply is from wells. 9 In consequence of bad water samples being obtained from the well supplying "Mary Ada" Cottage and "Tumour's Hall" Cottages at Chigwell, it was arranged for these properties to be put on the main supply from the Metropolitan Water Board. A bad sample was also obtained from "Broadstroode Lodge," Keeper's Cottage, Loughton, and the well there was cleaned out and some repair work carried out. A further sample was taken and again proved unsatisfactory. Up to the time of making this report a satisfactory sample has not been obtained and the tenant has been instructed to boil the water before drinking pending the result of further investigation. It is not practicable in this case to arrange for a supply from the Metropolitan Water Board. (ii) Drainage and Sewerage— The outfall works at Luxborough, brought into service last year, are functioning very efficiently and producing a satisfactory effluent. It is now anticipated that the alteration and enlargement of the Roding Road Pumping Station will be completed by the middle of next year, when the old Loughton Works will be put completely out of service. The pumping station at Pyrles Lane has been dispensed with during the year by a connection to the outfall sewer from Debden to Loughton. The small works at Millers Lane remains in service and whilst the intended improvements there had to be deferred because of the war, certain minor modifications were made and the effluent, in the circumstances, has been very satisfactory. 2. Rivers and Streams— The River Roding is the only one passing through the centre of the district dividing the wards of Chigwell on the south-east side and Buckhurst Hill and Loughton on the north-west side. There are no buildings at present liable to floods in the area which is under the jurisdiction of the Roding Catchment Board. 3. (i) Closet Accommodation— A few closets on the conservancy system remain in Chigwell and Loughton Wards. They are situated in remote cottages out of the reach of sewers. 10 (ii) Public Cleansing— House refuse is removed weekly by covered motor vans under contract. The refuse is disposed of at the contractors' own tip near the district boundary, the contract requiring that the precautions and methods of controlled tipping shall be adopted. Butchers' offal and refuse from fish shops is disposed of at the tip adjoining Loughton Sewage Works, being delivered there by the tradesmen and dealt with under the Engineer and Surveyor's instructions. A small charge is made for the facilities given. Putrescible refuse from greengrocers' shops is deposited at this tip also but is dealt with without charge. During the late summer months, considerable trouble was experienced from fly nuisance in the neighbourhood of the refuse tip at Buckhurst Hill, a number of complaints being received from the occupiers of adjoining houses. The tip was kept under constant supervision by this department and amongst the measures taken to alleviate the nuisance were the following:— (1) Pamphlets advising the occupiers how they could co-operate in exterminating flies were distributed to all houses in the vicinity of the tip. (2) Borax was supplied free, on application, to these holders. (3) The tip itself was sprayed daily with water containing borax on those parts of it in which the trouble arose. (4) Every effort was made to speed up the covering of the deposited refuse. The contractors, Messrs. W. & C. French, Ltd., co-operated in the work, and the nuisance gradually ceased as the weather became cooler. Salvage has received considerable attention during the year and efforts to increase the quantity of useful material have met with considerable success. Collection of salvage is done with the refuse collection and by the same contractor. Trailers are attached for paper and arrangements are made to keep the more important materials separate. Road gullies (in streets under the Council's control) are emptied by a mechanical suction process. The gullies are cleared three times in each year and are re-sealed with clean water after each emptying. 11 (iii) Sanitary Inspection of the Area. The Work of the Sanitary Inspectors is given below. Further details will be found in the Summary at the end of the report. No. of Inspections made 2,856 „ „ Summons or legal proceedings Nil „ „ Cesspools cleaned 4 „ ,, ,, dispensed with 10 ,, ,, Nuisances abated 112 ,, ,, Formal Notices served 2 ,, ,, Informal Notices served 94 ,, ,, Informal Notices complied with 79 „ „ Formal Notices complied with 1 ,, ,, Complaints received 30 Summary of Nuisances. Animals improperly kept Nil Cellars flooded 2 Cesspool overflows 4 Drains blocked or defective 71 Manure from stables, etc. 1 Polluted ditches and streams 3 Refuse dumps, etc 1 Rubbish burning 1 Sheds used for habitation 2 Absence of W.C. accommodation 2 Water closets defective 17 Water supply—defective or cut off 8 112 12 Verminous Houses.- No houses were found to be verminous during the year. Rats and Mice (Destruction) Act, 1919. The work of rat destruction was continued throughout the year as opportunity arose. Efforts were continued to prevent the increase of the number of rats on farms and on the Council's sewage works. At the refuse dump at Buckhurst Hill the contractors engage a firm of specialists to deal with rat destruction. The methods used for rat destruction are still the same, i.e., gassing by a Cyano gas pump and baiting with Red Squill, and satisfactory results continue to be obtained by these methods. Rat bait is supplied free on application to residents in the district. At the end of the year a campaign was started against rats by the Essex War Agricultural Committee, and the Public Health Department co-operated with them in an effort to make this a success. The following steps were taken:— (1) A reward of a penny for each tail brought in was offered by the Council. (2) A slide was exhibited at the local cinema advertising the above. (3) Farmers, butchers, bakers, wardens' posts and various other places were notified of the campaign. (4) Some ratting was carried out at likely places in the district. The results of the campaign were somewhat disappointing as only 45 tails were brought in up to the end of December, although of course this figure did not necessarily represent the number of rats destroyed. All expenses were defrayed by the Essex War Agricultural Committee. Number of visits—67. (iv) Smoke Abatement—No action taken. 4. Schools— The sanitary conditions and water supply are satisfactory. In several schools it was found necessary to clear blocked drains whilst the buildings were occupied by evacuees. 13 Section D. HOUSING STATISTICS FOR THE YEAR 1940. Number of new houses erected during the year 1940. (a) Total (including numbers given separately under (b)) 1. By Local Authority Nil 2. By other Authorities Nil 3. By other bodies and persons Nil (b) With State assistance under the Housing Acts. 1. By Local Authority Nil 2. By other bodies and persons Nil Inspection of Dwelling Houses during the Year. 1. (a) Total number of Dwelling-houses inspected for housing defects (under Public Health and Housing Acts) 49 (b) Number of Inspections made for the purpose 135 2. (a) Number of Dwelling-houses (included under sub-head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 9 (b) Number of Inspections made for the purpose 33 3. Number of Dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation Nil (4) Number of dwelling-houses (exclusive of those referred to under the preceding sub-head) found not to be in all respects reasonably fit for hitman habitation 49 Remedy of Defects During the Year without Service of Formal Notices. Number of defective dwelling-houses rendered fit in consequence of informal action by the Local Authority or their Officers 49 Action under Statutory Powers during the Year. (a) Proceedings under Sections 9, 10 and 16 of the Housing Act, 1936. (1) Number of dwelling-houses in respect of which notices were served requiring repairs 2 (2) Number of dwelling-houses which were rendered fit after service of formal notices:— (а) by Owners 1 (b) by Local Authority in default of Owners 1 14 (b) Proceedings under Public Health Acts. (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied Nil (2) Number of Dwelling-houses in which defects were remedied after service of formal notices:— (a) by Owners Nil (b) by Local Authority in default of Owners Nil (c) Proceedings under Sections 11 and 13 of the Housing Act, 1936. (1) Number of dwelling-houses in respect of which Demolition Orders were made Nil (2) Number of dwelling-houses demolished in pursuance of Demolition Orders Nil (d) Proceedings under Section 12 of the Housing Act, 1936. (1) Number of separate tenements or underground rooms in respect of which Closing Orders were made Nil (2) Number of separate tenements or underground rooms in respect of which Closing Orders were determined, the tenement or room having been rendered fit Nil Housing Act, 1936—Part IV—Overcrowding. (a) (i) Number of dwellings overcrowded at the end of the year See (e) (ii) Number of families dwelling therein See (e) (iii) Number of persons dwelling therein See (e) (b) Number of cases of overcrowding reported during the year See (e) (c) (2) Number of cases of overcrowding relieved during the year See (e) (d) Particulars of any cases in which dwelling-houses have again become overcrowded after the Local Authority have taken steps for the abatement of overcrowding See (e) (e) Any other particulars with respect to overcrowding conditions upon which the Medical Officer of Health may consider it desirable to report:— Since September, 1940, considerable number of evacuees from bombed areas have been received into the district and it would not be possible without complete re-survey of the district to give particulars under the above headings. 15 Summary of Defects. Defective Roofs 20 ,, Walls and Windows 12 „ Gutters and Rain-Water Pipes 6 „ Floors (Wood) 8 „ Paving 2 „ Sash Cords 6 ,, Plaster 12 Blocked or defective Drains 71 Dampness 10 Defective Water Closet 10 „ Water Waste Preventer 5 Sink and Waste Pipes 6 Cleansing of Walls and Ceilings 10 Lack of Ashbins 1 Miscellaneous, including stoves 11 Housing Act, 1936— The number of houses overcrowded at the end of the year was :—See remarks under Part IV (e). The issue of certificates showing permitted numbers to the end of the year is as follows:— To the end of To the end of 1939 1940 Buckhurst Hill 334 341 Chigwell 162 169 Loughton 371 384 Number of visits, 25. Section E. INSPECTION AND SUPERVISION OF FOOD. (a) Milk Supply— There are 15 cowkeepers on the register for the district, 6 produce and retail and 9 produce and sell wholesale; 169 visits have been made during the Year. The cowsheds have been maintained in a satisfactory condition. 24 samples of milk were taken and submitted to the County Laboratories for examination and the results were satisfactory in 18 cases. Further samples were taken in respect of the unsatisfactory ones and satisfactory results ultimately obtained. Three bottles were tested for efficient cleansing. The result of the first test was unsatisfactory and of the second two satisfactory. Licences to produce Tuberculin Tested and Accredited Milk have all been renewed during the year. 16 The number of farms producing Graded and Ungraded milk are— Tuberculin Tested (Certified) Accredited Ordinary I II 3 There are 18 Dairies and Milkshops on the register. 91 visits were made. There are 36 retail purveyors of milk on the register. Milk to Schools— Milk supplied to Schools during the year was Accredited, Pasteurised and ordinary. Biological examinations were made in respect of four samples taken by the County Council and all were unsatisfactory. Better results were, however, obtained in respect of the samples taken by this Department as will be seen from the remarks above. (b) Meat and other Foods— There are 7 Slaughterhouses in the district, now all licenced under the Food and Drugs Act, 1938. 67 visits were made. The following animals were slaughtered during the year :— CARCASES INSPECTED AND CONDEMNED. Cattle, excluding Cows. Cows. Calves. Sheep and Lambs Pigs. Number Killed 15 2 7 42 22 Number Inspected 15 2 7 42 22 All Diseases except Tuberculosis. Whole carcases condemned Nil. Nil. Nil. Nil. Nil. Carcases of which some part or organ was condemned 1 Nil. Nil. Nil. Nil, Percentage of the number inspected affected with disease other than Tuberculosis 6'66 Nil. Nil. Nil. Nil. Tuberculosis only. Whole carcases condemned Nil. Nil. Nil. Nil. Nil. Carcases of which some part or organ was condemned 2 Nil. Nil. Nil. Nil. Percentage of the number inspected affected with Tuberculosis 1333 Nil. Nil. Nil. Nil. 17 In addition, the following food was condemned as unfit for human consumption :— 51 lbs. bacon. 11 lbs. butter. 14 lbs. cod fillets. 36^ lbs. cooked tinned ham. 3 sheeps' heads, 3 sheep plucks, ½ bullock's head. As a result of enemy action the following food was found to be contaminated with particles of broken glass and was condemned:— 2 packets Jellicrest. 2 pudding mixtures. 2 blancmange powders. 1 table cream. 1 honeycomb cream. 4½ lbs. neck and breast lamb. 1 box " Wheatabix." 594 one penny cakes. 1 packet quaker rice. 1 packet quaker wheat. 5 lbs. mixed sweets. 7 lbs. rice. 4 lbs. rashers of bacon. 1½ lbs. ham. 1 lb. custard powder. 2 lbs. strawberry jam. 1 pot honey. 3 packets " Wheatabix." 1 tin apricots. There are 9 Bakehouses in the district and all these are kept in good condition. Number of visits—110 There are four Fish Friers in the urban district and the premises are in good order. Number of visits—15. The food shops are kept under observation. Number of visits—382. (c) Ice Cream—Food and Drugs Act, 1938. Number of Registrations, on 31st December, 1940 54. No. of Visits—76. 18 (d) SHOPS ACT, 1934. Class of Shop. Lock-up. Otherwise. Total Buck. Hill. Chigwell. Loughton. Buck. Hill. Chigwell. Loughton. Animal Clinic — — 1 — — — 1 Art Needlework 1 — 1 1 — 1 4 Bakers — — 2 3 1 8 14 Bazaar — — 1 — — — 1 Boots and Shoes 2 1 5 3 — 3 14 Builders' Merchant 1 — 4 1 1 — 7 Butchers 3 1 6 6 1 5 22 Chemists 3 — 5 1 1 1 11 China, Glass and Hardware 1 2 1 - 1 5 Coal Merchants 2 — 3 — — — 5 Confectioners 1 1 3 — 2 5 12 Cooked Food Stores 1 — — — — 1 2 Corn Merchants 1 — — — — — 1 Costumiers — — 1 — - — 1 Cycle, Radio and Sports 1 — 1 1 - 3 6 Dairy — 1 2 1 - 2 6 Domestic Stores — — — 1 - — 1 Draper — — 4 5 2 2 13 Dressmaker — — — 1 - — 1 Dyers and Cleaners 1 1 4 — - 1 7 Electrical Showrooms — — 1 — - — 1 Fishmongers 1 — 1 2 - 1 5 Florist 1 — 1 — - 2 4 Fried Fish 1 — 1 1 - 1 4 Furniture — — 1 2 - — 3 Gas Show Rooms — — 1 — - — 1 General Merchants 2 — 3 — - — 5 General Stores 2 — 3 2 8 7 22 Golf Club — — — — 1 — 1 Greengrocer 4 1 6 3 — 5 19 Grocer 2 — 1 2 1 1 7 Carried forward 31 6 64 37 18 50 206 19 Class of Shop. Lock-up. Otherwise. Total. Buck. Hill. Chigwell. Loughton. Buck Hill. Chigwell. Loughton. Brought forward 31 6 64 37 18 50 206 Grocer and Provision Merchant 3 - 5 4 - 6 18 Hairdresser 2 1 8 3 — 1 15 Ironmonger — — 3 3 — 1 7 Library — — 2 1 1 — 4 Licensed Premises — — — 11 8 11 30 Newsagent 1 — 1 2 1 1 6 Newsagent and Tobacconist - - 1 2 2 2 7 Off Licence — — — 1 1 3 5 Optician 1 — — — — — 1 Outfitters — — 2 1 — 4 7 Photographer 1 1 Provision Merchant — — — — — 1 1 Saddler — — 1 — — — 1 Sewing Machines — — 1 — — — 1 Stationer — — 1 — — 1 2 Tailor — — — 1 — — 1 Teashops 1 1 4 4 9 1 20 Tobacconist — — — — — 1 1 Tobacconist and Confectioner 3 1 2 8 5 6 25 Toys and Fancy Goods — — — — — 1 1 Watchmaker and Jeweller 2 1 3 Wine and Spirit Merchants — — — 1 - 1 2 Totals 42 9 97 80 45 92 365 Number of Visits 33. (e) Adulteration—This is dealt with by the County Council. (f) Chemical and Bacteriological Examination of Food— This is dealt with by the County Council. (g) Nutrition—No action. 20 Section F. PREVALENCE OF, AND CONTROL OVER, INFECTIOUS AND OTHER DISEASES. The incidence of infectious disease was low throughout the year and our fears that we might be called upon to face serious winter epidemics, particularly of influenza, were fortunately not realised. The reason for this must remain a matter for speculation, but the enforced decrease in assemblies of persons at cinemas and other meeting places no doubt operated as a favourable factor on the situation, moreover, the regular shelter population in the district was small even during the period of heavy air attack on London. There is no evidence that the health of children has suffered, hitherto, either physically or psychologically as the result of rationing, disturbed nights or overcrowded sleeping conditions. On the other hand, there are signs of a fall in general standards of cleanliness, particularly amongst school children. In one school in the district 12% of the children were found (early in 1941) to have dirty heads, and there are signs also of an increase in scabies amongst the population generally. The problem, so far as children are concerned, must be attacked through the school nurses and health visitors, but the steam disinfection of bedding and clothing is carried out when necessary in cases brought to the notice of the health department. Unfortunately, information is received of what is probably but a small proportion of the total number of cases and the compulsory notification of scabies and other verminous conditions, by doctors and health visitors, might well lead to more immediately practical and useful results than the recently introduced notification of measles and whooping cough. Diphtheria Immunisation. Immunisation clinics were held regularly once a month at all Child Welfare Centres throughout the year, and in addition, the general practitioner's scheme provides for treatment by a child's own doctor, if desired. 21 A summary of the work done during the year, compared with 1939, is given below:— 1. At Clinics— 2 doses of A.P.T.,0.2 c.c. and 0.5 c.c., at one month's interval. Age Groups 1939. 1940. M. F. M. F. 1— 5 years 46 28 58 62 5—10 „ 11 4 9 9 10—14 „ — 2 — 2 14 „ upwards — 1 1 — Total 57 35 68 73 2. By General Practitioners— 2 doses of A.P.T. or 3 of T.A.F. Age Groups 1939. 1940. M. F. M. F. 1— 5 years 3 3 24 14 5—10 „ 1 3 9 5 10—14 „ — — — 3 14 ,, upwards — — — 1 Total 4 6 33 23 Total number of cases immunised at Clinics and by General Practitioners 1939 = 102 1940 = 197 Typhoid Fever. In the latter part of the year, arrangements were made for the free prophylactic inoculation of A.R.P. personnel by the Medical Officer of Health and of the general public by private practitioners, with T.A.B. vaccine. Particulars of those treated are given below:— M. F. Total. A.R.P. personnel; 2 injections T.A.B. vaccine at interval of 10—14 days 32 71 103 General public by private medical practitioners 18 21 39 142 22 Summary of Cases of Infectious Diseases, showing Number of Cases, Admission to Hospital and Deaths. Infectious Disease. Total Cases (Notified). Admissions to Hospital. Deaths Registrar General's Figures, Scarlet Fever 21 15 0 Diphtheria 2 2 0 Cerebro Spinal Fever 2 2 2 Puerperal Pyrexia 5 3 1 Erysipelas 5 1 0 Measles 19 3 0 Whooping Cough 4 0 0 58 26 3 TUBERCULOSIS. Age. New Cases. Deaths. Respiratory. Non-Respiratory. Respiratory. Non-Respiratory M F M F M F M F Under i year - - - - - 1 - - 1 and under 5 — — 1 — — — — — 5 „ „ 15 — 1 2 2 — — — — 15 „ „ 25 4 1 — — — 2 — — 25 „ „ 35 5 2 1 — 2 1 — — 35 „ „ 45 2 2 — — 2 1 — — 45 „ „ 55 2 — — — 1 — — — 55 „ „ 65 — 1 — — 1 — — — 65 and upwards 1 1 — — 1 — — — Totals 14 8 4 2 7 5 — — M. — Male. F.—Female. Deaths . Number of months before death notified:— Notified p.m. 1 ,, 1— 3 months before death 1 ,, 3- 6 ,, ,, 3 ,, 6—12 „ „ 1 „ 1— 2 years „ „ 3 ,, 2— 3,, ,, 3 12 28 Summary of Sanitary Inspector's Visits during the Year ended 31st December, 1940. Nature of Visit or Inspection No. of Visits. General Sanitation. Water Supply 142 Drainage 54 Stables and Piggeries 1 Fried Fish Shops 6 Factories 9 Workshops and Workplaces 30 Bakehouses 110 Refuse Collection 1 Refuse Disposal 35 Rats and Mice 67 Schools 1 Shops 33 Knackers Yard 15 Petroleum 58 Miscellaneous Sanitary Visits 532 Billets 20 Re Refugees 140 Public Shelters 28 1,742 Under Public Health Acts. Housing. Number of houses inspected 40 Visits paid to above houses 102 Under Housing Acts. Number of houses inspected 9 Visits paid to above houses 33 Overcrowding. Number of Houses Inspected 4 Visits paid to above houses 21 Verminous Premises. Number of houses inspected 1 Visits paid to above houses 1 Miscellaneous Housing Visits (a) 15 Infectious Diseases. 226 Inquiries in cases of Infectious Disease 24 Visits re Disinfection 40 Miscellaneous Infectious Disease Visits 14 78 Meat and Food Inspection. Visits to Slaughterhouses 67 ,, „ Butchers 179 ,, ,, Fishmongers and Poulterers 15 ,, ,, Grocers 57 ,, ,, Greengrocers and Fruiterers 21 ,, ,, Cowsheds 169 ,, ,, Dairies and Milkshops 91 ,, ,, Ice Cream Premises 76 ,, ,, Restaurants 1 ,, ,, Food Preparing Premises 3 Visits in Connection with Sampling. Milk—Bacteriological 10 Miscellaneous Food Visits 121 810 Total 2,856 House refuse is collected under the supervision of Mr. G. Holbourn, A.M.Inst., C.E., Engineer and Surveyor. (Signed) J. T. HEATH, M.R.San.I., M.S.I.A., Senior Sanitary Inspector, (a) Including visits made under Housing Act, 1936. 24 Air Raid Precautions. The time will come, no doubt, when the work done by the various A.R.P. services will be duly recorded. It must suffice here to say that during the year the members of the casualty service had their first experience of the " real thing " and, as was confidently expected, acquitted themselves with courage and efficiency. My personal thanks are due to the Medical Officers in charge of First Aid Posts and Mobile Unit, Drs. Bell, Walker, Anderson, Matland, Roberts and Voller, the latter also for his training of the stretcher parties, Mrs. Hawkey, as Ambulance Officer, the Sisters in charge of First Aid Posts and Mobile Unit, Mrs. Platten, Miss Bishop, Mrs. Kearney, Mrs. Williams and Mrs. Ashwell, and to Mr. Brooman, the supervisor of the stretcher parties, for their unfailing help at all times. L.S.F. APPENDIX. RAINFALL IN INCHES BY MONTHS FOR 1940. Buckhurst Hill. High Beech. January 2.19 5.49 February 1.68 1.55 March 3.29 3.08 April 1.78 1.73 May 1.81 1.74 June 0.73 0.51 July 3.07 3.34 August 0.l0 0.08 September 0.86 0.95 October 2.88 3.19 November 6.41 6.83 December 1.28 1.24 Totals 26.08 29.73 The highest point in the District is 372 O.D., and the lowest 44 O.D. CONTENTS OF THE REPORT FOR 1940. pages. Report—Medical Officer of Health's Letter 1 Public Health Committee 2 Public Health Staff 2—3 Statistics and Social Conditions of the Area 3 Vital Statistics 4 Causes of Deaths 4 Analysis of Deaths according to age incidence 5 Number of Deaths by Years 5 Comparative Table, Birth and Death Rates 5 Table of Birth Rates, Death Rates and Analysis of Mortality 6 General Provisions of Health Services in the District 7—8 Ambulance Calls 7 Sanitary Circumstances of the Area 8—9 — 10—11—12 Housing Statistics for the Year 13—14—15 Housing Act, 1936 13—14—15 Inspection of, and Supervision of, Food 15—16—17 Shops 18—19 Prevalence of, and Control over, Infectious Diseases 20—21— 22 Summary of Inspector's Visits 23 Air Raid Precautions 24 Meteorological Record—Rainfall 24